title: PET/CT-guided percutaneous biopsy of abdominal masses: initial experience.
abstract: OBJECTIVE
  To develop a technique for guiding percutaneous biopsies of abdominal masses in a positron emission tomography (PET)/computed tomography (CT) scanner, and test its feasibility and safety in patients.
  
  
  METHODS
  The authors conducted a prospective study in 12 patients who were in need of both a diagnostic (18)F-fluoro-deoxy-D-glucose (FDG) PET/CT scan and a percutaneous biopsy of an abdominal mass, located in the liver (n = 7), presacral soft tissue (n = 2), lymph node (n = 2), and kidney (n = 1). After completion of the PET/CT scan, with the patient remaining on the table, a one-table-position PET/CT scan was obtained with a radiopaque grid in place, and the biopsy procedure was planned. Then, a biopsy needle was placed into the mass using one-table-position CT scan registered to the planning PET scan. Masses were sampled after confirming accurate positioning of the needle tips with a final one-table-position PET/CT scan. Negative results were confirmed independently with follow-up imaging.
  
  
  RESULTS
  All biopsy procedures yielded diagnostic results; nine were positive for malignancy, and three were negative (fibrosis, steatosis, and Escherichia coli infection). One non-FDG-avid mass biopsy yielded a malignant result. Seven masses were either invisible or poorly depicted with unenhanced CT scan, and two masses contained FDG avidity in only a portion of the mass. There were no complications.
  
  
  CONCLUSIONS
  Although our data are preliminary, this initial experience suggests that abdominal masses can undergo successful biopsy in a PET/CT scanner. PET/CT guidance may be helpful when performing biopsy on FDG-avid masses that are either not visible with unenhanced CT or are FDG avid in only a portion.
authors.affiliation: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. statli@partners.org
authors.forename: Servet
authors.initials: S
authors.lastname: Tatli
authors.forename: Victor H
authors.initials: VH
authors.lastname: Gerbaudo
authors.forename: Christina M
authors.initials: CM
authors.lastname: Feeley
authors.forename: Paul B
authors.initials: PB
authors.lastname: Shyn
authors.forename: Kemal
authors.initials: K
authors.lastname: Tuncali
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Silverman
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001900:Boston; D004067:Digestive System Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods*; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18